Dear Drugs-Forum readers: We are a small non-profit that runs one of the most read drug information & addiction help websites in the world. We serve over 3 million readers per month, and have costs like all popular websites: servers, hosting, licenses and software. To protect our independence we do not run ads. We take no government funds. We run on donations which average $25. If everyone reading this would donate $5 then this fund raiser would be done in an hour. If Drugs-Forum is useful to you, take one minute to keep it online another year by donating whatever you can today. Donations are currently not sufficient to pay our bills and keep the site up. Your help is most welcome. Thank you.

Okay so last night SWIM smoked some jwh-018 which is known for giving tachycardia and palpitations. He smoked 3mg and the normal dose is supposed to be 0.3-2mg so it was a decent dose. And the guy said he felt like he was going to die because his heart was beating 230+ bpm

Luckily the guy apparently is fine now, but wonders what could have happened if his heart was beating in excess for just a bit longer or a bit faster. Would he have had a heart attack? What could one do to prevent this happening with any drug?

If--IF--someone doesn't have any heart problems to begin with, it's usually okay for your heart to speed up in situations like exercise, adrenaline rushes, or cannabinoids. Probably the worst thing to do is get scared about it, since that'll just make your heart faster.

Lying down and breathing slowly is good, and one thing recommended to get rid of palpitations is the Valsalva maneuver. My professor described it succinctly as "pooping," and yeah, it's pretty much what happens when you strain to do so. You also get the same effect when you try to blow up a balloon that hasn't been stretched out first--stimulation of your vagus nerve, which slows down your heart.

Cardiology is ridiculously complex, but suffice to say it's okay for healthy people to get a fast heart rate, as long as it goes back to normal after a while.

Okay so last night SWIM smoked some jwh-018 which is known for giving tachycardia and palpitations. He smoked 3mg and the normal dose is supposed to be 0.3-2mg so it was a decent dose. And the guy said he felt like he was going to die because his heart was beating 230+ bpm

Luckily the guy apparently is fine now, but wonders what could have happened if his heart was beating in excess for just a bit longer or a bit faster. Would he have had a heart attack? What could one do to prevent this happening with any drug?

SWIM ended up in the ER last year, crying hysterically she is about to get a heart attack, because Ritalin LA caused palpitations.

She was so frightened, that she developed a panic attack, which of course raised the heart beat even more.

As far as I know, if you're healthy with no previous heart conditions, you should try to calm down, get some rest and avoid panic, because it will only make things worse.
In the worst case scenario, in SWIM's home country an emergency hotline nurse told her to go to the doc on call at her clinic (there is always one doc on a night shift) and then he can give a patient a beta blocker...but that's quite extreme.

When SWIM had very fast heart beat issues (caused by Ritalin) 2 months ago, she googled a bit and found an article about a pill similar to Aspirin (here it's called "Micropirin"), which indeed turned out to be very helpful in slowing down SWIM's heart rate. It's one of those on the counter drugs.

Post Quality Evaluations:

Self-incrimination. Tell us about a friend or your pet purple penguin. Read the Forum Rules.

Last edited by AlexaN; 13-07-2010 at 13:34.
Reason: self incrimination

Okay so last night SWIM smoked some jwh-018 which is known for giving tachycardia and palpitations. He smoked 3mg and the normal dose is supposed to be 0.3-2mg so it was a decent dose. And the guy said he felt like he was going to die because his heart was beating 230+ bpm

Luckily the guy apparently is fine now, but wonders what could have happened if his heart was beating in excess for just a bit longer or a bit faster. Would he have had a heart attack? What could one do to prevent this happening with any drug?

Swim was once on adderall, smoked weed, and then went on a run. He stopped when he started to feel like there was something terribly wrong, and counted his heart rate as 220bpm. His HR was around 120-130 while lying down, and standing up it would shoot to 180bpm for the next few hours. Swim went to the doctor later and they said his heart was fine, so as others have said, if one does not have a pre-existing condition and is relatively young, these heart rates are dangerous but swiy can be ok. However a 230+ heart rate is nothing to take lightly, swiy should talk to a doctor just in case.

SWIM always has the rescue of the alpha blocker effects of olanzapine. Beta blockers are dangerous to lower blood pressure and pulse in drug-induced situation. Alpha blockers are preferred, and atypicals are perfect for that.

SWIM always has the rescue of the alpha blocker effects of olanzapine. Beta blockers are dangerous to lower blood pressure and pulse in drug-induced situation. Alpha blockers are preferred, and atypicals are perfect for that.

A heart rate over 100 is clinically considered to be tachycardia (too fast) but its taken in consideration with other symptoms upon presentation. If SWIY clocks in at 120bpm its not necessarily a means for a 911 call. However something like 150+ is certainly means to contact a physician or nurse and if its accompanied by other disruptions or symptoms warrants a trip to the ER.

SWIM has to advise against the unsupervised use of Beta or Alpha blockers or any other sort of heart-stabilization medication. These medications are not 'take-as-you-please' or PRN medications and can be extremely dangerous. Messing with drugs that are designed to affect one's heart is probably a more likely danger to one's heart than the drug that may be fault for causing tachycardia.

If SWIY's heart rate is so high again, SWIM strongly suggests SWIY go immediately to the ER where - if warranted - it can be corrected with appropriate 'as-needed' IV medication and SWIY can properly be monitored.

A heart rate over 100 is clinically considered to be tachycardia (too fast) but its taken in consideration with other symptoms upon presentation. If SWIY clocks in at 120bpm its not necessarily a means for a 911 call. However something like 150+ is certainly means to contact a physician or nurse and if its accompanied by other disruptions or symptoms warrants a trip to the ER.

SWIM has to advise against the unsupervised use of Beta or Alpha blockers or any other sort of heart-stabilization medication. These medications are not 'take-as-you-please' or PRN medications and can be extremely dangerous. Messing with drugs that are designed to affect one's heart is probably a more likely danger to one's heart than the drug that may be fault for causing tachycardia.

If SWIY's heart rate is so high again, SWIM strongly suggests SWIY go immediately to the ER where - if warranted - it can be corrected with appropriate 'as-needed' IV medication and SWIY can properly be monitored.

Best of Luck,
-CAN

Swim has heard/experienced that heart rates can rise above 100bpm, even to 120+, when using cocaine. Also, when swim has been on MDMA, his resting heart rate will be below 100bpm, but after dancing for a while, his HR can get up to 140+. However, wouldn't that be normal, as dancing heavily even while sober can get ones HR to 140+?

The appropriate antihypertensive drugs to administer during hypertensive crisis resulting from stimulant abuse are vasodilators like nitroglycerin, diuretics like furosemide and alpha blockers like phentolamine. [17]

First of all it is worth remembering that everyone is different (can I have my Stating the Obvious award now please?). For some people, especially the elderly, a resting heartbeat of 100, while not ideal, is normal & not necessarily indicative of any problems. For an adult between 18 & 65 a resting heartbeat of between 60 & 100 beats per minute is considered healthy, below 60 is considered bradycardic (although some athletes may record this without problems) & above 100 is tachycardic.

It is definitely worth obtaining a baseline (i.e sober, at rest, non-anxious) reading from a professional or at least someone who has experience of obtaining accurate readings. Obtaining an accurate pulse measurement is not as easy as it seems & take practise. What is doubly tricky is obtaining an accurate reading on one's Self, especially if chemically altered - even when sober it is easy to lose count or lose track of time if doing it properly & counting for the full minute. You can take a reading for 15 or 30 seconds & multiply by 4 or 2 respectively, but this does not give an accurate reading.

Heavy exercise, such as dancing will indeed raise the heartrate to 120, 140, maybe considerably more. This is not necessarily a problem. The problem is when the heartrate does not return to "normal" after a few minutes. Of course, if stimulants have been taken, this may not happen! Polydrug use will also have a negative effect, as the heart is trying to cope with several different substances' effects at once.

So, as well as knowing your monkey's resting heartbeat when sober, it may also be useful to know your monkey's resting heartbeat when under the influence. The problem with this is that most stimulants available, especially "street" stimulants, are not standardised doses & the effect they have physiologically is potentially going to be different every time. If several things (& that includes coffee, cigarettes, alcohol, cannabis, you know, things that people forget are drugs) have been taken (="polydrug use") it is not going to be possible to assess which drug's effect is being measured, or even which one is causing the apparent rapid heartbeat. Also, why waste an experience worrying about whether one's pulse is raised, potentially leaving one open to a panic attacks & paranoia inducing experiences?

People who may have cause for concern about stimulant use & it's effect on the heart really should be avoiding stimulants, & that includes hypochondriacs!

As an aside, Dextro, still waiting for those references about atypical antisychotics being perfect for reducing heartrate in this situation. Unprescribed use of antipsychotics for any purpose is not recommended & can indeed be dangerous, potentially causing extra-pyramidal side-effects, blood pressure issues & tachycardia as the body tries to compensate for the sudden sedation.

SWIY raises a valid question. Yes, there is a difference between your resting heart rate and your active heart rate (such as your example of dancing).

While tachycardia may be clinically defined as a BPM greater than 100, clinical thresholds are not, in and of themselves, concrete cut off points at while your 'fucked'.
For instance, smokers tend to have higher resting heart rates, and being around 100BPM is not uncommon. It doesn't mean they are going to die or even suffer cardiac damage. Where we become worried about something like Tachycardia is when your WAY past the clinical threshold, like 160BPM lying down or something. But even this has to be considered in conjunctions with any other presenting symptoms.

For isntance, Bradycardia (heart too slow) is generally considered to be less than 50BPM, though there are other clinical thresholds in different areas. But some athletes have been known to have heart rates well below the Brady area who are perfectly fine, in fact their heart not having to beat anywhere near as fast as what we consider to be clinically 'normal' is actually a sign of significant health.

Empirical clinical thresholds are things that have been designed from the determination of what would fit those who occupy the bump in the bell curve. Being outside of it on either side does not necessarily imply pathology of any kind.

A great example of clinical thresholds that demostrates how much they are really just 'guidelines' is the Body Mass Index. People familiar with the BMI scale may have heard of instances when swimmers or other athletes have been deemed obese (sometimes even morbidly so) based on the BMI scale, when in fact they are very healthy and their mass is due to muscle tissue rather than an excess of fatty tissue.

Take everything with a grain of salt, and consider that if the only thing 'out of whack' is one empirical measure, but no other evidence of pathology can be determined, then its likely that one has merely encountered an individual who is just leaning towards the slimmer aspects of the bell curve.

I'm not sure if there is a conflict of opinion in this thread, but Micklemouse makes a very basic and very true point: everyone is different.

If anyone finds that their heart rate is consistently high and it concerns them, even in the absence of other complaints, there is absolutely nothing wrong with consulting their physician who is the one who can truly determine for someone if sitting outside the bell curve is something to be concerned about.

People may request references here not necessarily to be jerks or anything, but perhaps because they haven't heard that before. This is not an academic community but we should all be careful about what we state and how we do so. It is one thing to say "As far as I know" or 'In my opinion" etc, but to make a claim as if it is fact is another thing, not necessarily a reprehensible thing, but I think we should try not to be offended if someone requests the source of our information and there is nothing wrong with just saying "Well, in my experience..." etc.

I like to talk within the realm of what I know to be the medical context in my geographic region, but even what is considered to be a 'fact' here in my area, may not be elsewhere.

Another example is Blood Pressure. Clincially 140/100 is considered hypertensive (and this is a very simple break down since the top number and bottom number have indications of their own that can be dependant upon one another or entirely independent). 'Hypertensive' is technically pathological, but rocking out at around 146/101 or 158/95 or whatever doesn't necessarily mean something is wrong, or even that treatment is indicated. In some places anything outside of 120/80 is hypertensive (that is the target BP that I have been taught) but again, everyone is different and these clinical thresholds are guidelines used in practice.

Let's not get hung up on 'elitism' or anything like that. Especially over something like clinical thresholds.

The difference of opinion is not about clinical thresholds but is about off-label use of powerful sedative drugs to deal with what may or may not be a medical emergency outside of a medical environment, especially when those sedative drugs can have a negative effect on one's heart, including tachycardia. If one is suffering from a dangerously high heartrate then medical advice is what needs to be sought, not an atypical antipsychotic.

My issue is that potentially dangerous advice is being dished out with nothing to back it up. I am not trying to make this discussion difficult or elite. I am trying to ask you to back up your statements with research.

This is not only a drugs forum, it is also a harm reduction forum. If I see something that is potentially harmful then I am very likely to challenge it.

I apologise for not seeing your post above mine Dextro, as well as any misreading I may have done earlier. However, the way your first post reads implies that atypical antipsychotics should be used to counter rapid heartrate due to stimulants. This is what I took exception to.

However, a bit of digging will find that tachycardia is a side effect of at several atypical antipsychotics, including Olanzepine, & tachycardia is generally listed as a precaution for use of Olanzepine, making it a bad choice for use in an emergency.

As with other drugs that have high alpha-1 adrenergic receptor blocking activity, olanzapine may induce orthostatic hypotension, tachycardia, dizziness, and sometimes syncope especially at the initiation of treatment.

Just because it has a high alpha-blocking potential, it does not mean that it should be used outside of a medical setting for this purpose. Add to this the fact that you do not mention a dose, or what your monkeys history with antipsychotics is & you have a potentially very dangerous situation. Remember that specific alpha-adrenergic blockers do just that - they block alpha-adrenaline specifically. This is what they are designed to do. Antipsychotic drugs work on so many more levels, & more intensely, & are not to be messed about with, especially by those with no experience of them.

swim was given atenolol (beta-blocker) for his tachycardia, along with a benzo.
swims under the impression that this is a relatively safe med, and could be useful for those swiy with fast beating hearts

As Micklemouse has already stated, an integral part of this forum is harm-reduction, and therefore, if people are going to suggest unorthodox, and non-scientifically proven remedies for medical emergencies, they need to be able to provide proof of their assertions.

It is not simply enough to say "do your own research", when making statements like this, the burden of proof lies on the claimant

None of this is intended to "get at" or belittle anyone, but, rather, to ensure that DF remains a place of high quality information, focused on harm-reduction. This has nothing to do with WHO posts information, but rather HOW they do so

Differences of opinion are always welcome, and make for a much more interesting forum, but they need to be done without insults and flaming

In terms of alpha-blockers: They reduce Blood Pressure, they tend NOT lower pulse rate, and, due to reduction in BP, can actually cause a reflex tachycardia. Therefore, they should not be used in this situation.

Given that antipsychotics are associated with prolongation of the QT interval of the ECG (by effects on myocardial electrical depolarisation), and with tachycardia, including SVT and VF (including sudden death) this is a second reason their use could be dangerous in this situation

Antipsychotics are often used (although they shouldn't be, due to the risk of hypertensive crisis) in psychedelic freakout, this is not because of their effects on pulse rate, but due to them being a fast and effective way to sedate agitated individuals. Same for Benzodiazepines (which are far preferable)